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Wound management presents a significant global challenge, necessitating a comprehensive understanding of wound care products and clinical expertise in selecting dressings. Bioactive dressings (BD) represent a diverse category of dressings, capable of influencing wound healing through various mechanisms. These dressings, including honey, hyaluronic acid, collagen, alginates, and polymers enriched with polyhexamethylene biguanide, chitin, and chitosan derivatives, create a conducive environment for healing, promoting moisture balance, pH regulation, oxygen permeability, and fluid management. Interactive dressings further enhance targeted action by serving as substrates for bioactive agents. The continuous evolution of BDs, with new products introduced annually, underscores the need for updated knowledge in wound care. To facilitate dressing selection, a practical algorithm considers wound exudate, infection probability, and bleeding, guiding clinicians through the process. This algorithm aims to optimize wound care by ensuring the appropriate selection of BDs tailored to individual patient needs, ultimately improving outcomes in wound management. [ABSTRACT FROM AUTHOR]

Background: Xylazine is an alpha-2 adrenergic receptor agonist that has emerged as a contaminant in the illicit drug supply of fentanyl. Xylazine use may be suspected in naloxone-resistant overdoses and atypical, chronic wounds in people who use drugs (PWUD). This case is unique because it is the first case to our knowledge describing wound care for a xylazine-induced wound with a confirmatory xylazine test strip (XTS) in the setting of a syringe services program (SSP) and in the state of Florida. Case presentation: A 43-year-old woman with a past medical history of severe opioid use disorder and stimulant use disorder presented to a student-run clinic at a Miami SSP for wound care. She had multiple ulcerations diffusely over her bilateral forearms with surrounding erythema and warmth. Seven weeks later, she presented to clinic again for wound care because her wounds had progressed. At this visit, a XTS was used to confirm the presence of xylazine in her urine. Wound care management and harm reduction strategies employed at both visits were informed by best clinical judgement due to lack of formal guidelines at the time. Wound outcomes are unknown as the patient has not returned to clinic. Conclusions: Many PWUD at highest risk for acute and chronic health consequences of xylazine-adulterated fentanyl do not have access to healthcare outside of low barrier clinics and SSPs due to lack of insurance or mistrust of the traditional healthcare system due to stigma. There is an urgent need for access to XTS for PWUD and clinical practice guidelines for the treatment of xylazine-related wounds in outpatient clinics. [ABSTRACT FROM AUTHOR]

Summary: Recognition of the role that biofilms play in the persistence of wounds and lack of response to therapy in horses is increasing. Prevention of biofilm development in the early stages of wound care involves three primary strategies: wound debridement and cleansing to reduce bacterial counts in the wound bed, appropriate use of advanced wound dressings and implementation of topical antimicrobial agents. Once formed, eradication of biofilms requires elimination to improve the wound environment for contraction and epithelialisation while not further harming the native cells integral to the healing process, which is achieved predominantly through repeated lavage and debridement combined with topical antimicrobial therapy. Pseudomonas, Enterococcus and Staphylococcus bacterial species have been most commonly identified in equine wounds with delayed healing. This review will establish why and how biofilms form, how to recognise clinical indications that biofilms have formed in equine wounds and review current diagnostic options and biofilm‐based wound care strategies to eradicate biofilms. Clinical scenarios for cases in which biofilms developed and were successfully treated will be presented. This review will advance practitioners' understanding of the presence and role of biofilms in equine wounds and provide an updated summary of recommended treatment strategies. [ABSTRACT FROM AUTHOR]

Debridement is a core component of chronic wound management. Although various debridement methods exist, each carries a unique patient risk level. This article discusses the different normal tissue components that are critical to safe debridement practice, various methods of wound debridement for nurses, and the importance of an interprofessional team and consulting a wound specialist. [ABSTRACT FROM AUTHOR]

Wound healing is a complex process influenced by age, systemic conditions, and local factors. The wound microbiota's crucial role in this process is gaining recognition. This concise review outlines wound microbiota impacts on healing, emphasizing distinct phases like hemostasis, inflammation, and cell proliferation. Inflammatory responses, orchestrated by growth factors and cytokines, recruit neutrophils and monocytes to eliminate pathogens and debris. Notably, microbiota alterations relate to changes in wound healing dynamics. Commensal bacteria influence immune responses, keratinocyte growth, and blood vessel development. For instance, Staphylococcus epidermidis aids keratinocyte progression, while Staphylococcus aureus colonization impedes healing. Other bacteria like Group A Streptococcus spp. And Pseudomonas affect wound healing as well. Clinical applications of microbiota-based wound care are promising, with probiotics and specific bacteria like Acinetobacter baumannii aiding tissue repair through molecule secretion. Understanding microbiota influence on wound healing offers therapeutic avenues. Tailored approaches, including probiotics, prebiotics, and antibiotics, can manipulate the microbiota to enhance immune modulation, tissue repair, and inflammation control. Despite progress, critical questions linger. Determining the ideal microbiota composition for optimal wound healing, elucidating precise influence mechanisms, devising effective manipulation strategies, and comprehending the intricate interplay between the microbiota, host, and other factors require further exploration. [ABSTRACT FROM AUTHOR]

Objectives: Xylazine has emerged as a consistent part of the unregulated drug supply in recent months. We discuss major domains of xylazine's harm, current knowledge deficits, clinical and harm reduction strategies for minimizing harm, and xylazine's public health and policy context. As an interdisciplinary team from across the USA, we have pooled our knowledge to provide an overview of xylazine's current and emerging contexts. Methods: To inform this essay, the pertinent literature was reviewed, clinical knowledge and protocols were shared by multiple clinicians with direct expertise, and policy and public health context were added by expert authors. Results: We describe xylazine's major harm domains—acute poisoning, extended sedation, and wounds, along with anemia and hyperglycemia, which have been reported anecdotally but lack as clear of a connection to xylazine. Current successful practices for xylazine wound care are detailed. Understanding xylazine's epidemiology will also require greater investment in drug checking and surveillance. Finally, approaches to community-based wound care are discussed, along with an orientation to the larger policy and public health context. Conclusions: Addressing the harms of xylazine requires interdisciplinary participation, investment in community-based harm reduction strategies, and improved drug supply surveillance. The relatively unique context of xylazine demands buy-in from public health professionals, harm reduction professionals, clinicians, basic science researchers, policymakers and more. [ABSTRACT FROM AUTHOR]

Many nurse educators consider simulation a valuable tool to supplement and augment learning due to current shortages of clinical placements. Wound care is integral to nursing practice yet many students and practicing nurses experience difficulties in securing sufficient learning opportunities or experience at the undergraduate level to feel competent in providing it. Emerging evidence supports simulation as a promising intervention to facilitate student learning in wound care, building nurses’ confidence and competence in providing evidence-based wound care. Objective: To understand how clinical simulation is being used to educate nurses about wound assessment and management, and to explore the impact of clinical simulation on learning outcomes, including knowledge, attitudes, confidence, and skills related to wound care. Inclusion criteria: Inclusion criteria include studies of nursing students and nurses, simulation educational interventions, and learning outcomes related to wound care evaluated by any measures. Any studies that do not fit these criteria will be excluded. Methods: Databases to be searched include PubMed/MEDLINE, CINAHL, ERIC, SciELO up to February 2022. Studies in English with a date limit of 2012 to 2022 will be included. Search results will be imported into Covidence and screened by two independent reviewers, first based on the title and abstract and then full text. Data will be extracted with a novel extraction tool developed by the reviewers and then synthesised and presented in narrative, tabular, and/or graphical forms. Dissemination: The finished scoping review will be published in a scientific journal once analysis is completed. [ABSTRACT FROM AUTHOR]

This study was designed to establish the composition of wound dressing based on poly(2‐hydroxyethylmethacrylate)‐chitosan (PHEM‐CS) hydrogels‐loaded cerium oxide nanoparticle (CeONPs) composites for cutaneous wound healing on nursing care of the chronic wound. The as‐synthesised PHEM‐CS/CeONPs hydrogels nanocomposites were characterised by using UV–visible spectroscopy, scanning electron microscopy, Fourier transform infrared spectroscopy, X‐ray diffraction, and thermo gravimetric analysis. The influence of PHEM‐CS/CeONPs hydrogels nanocomposites on the gelation time, swelling ratio, in vitro degradation, and mechanical properties was investigated. The as‐prepared PHEM‐CS/CeONPs hydrogels nanocomposites dressing shows high antimicrobial activity against Staphylococcus aureus and Escherichia coli. Similar trends were observed for the treatment of biofilms where PHEM‐CS/CeONPs hydrogels nanocomposites displayed better efficiency. Furthermore, the biological properties of PHEM‐CS/CeONPs hydrogels nanocomposites had non‐toxic in cell viability and excellent cell adhesion behaviour. After 2 weeks, the wounds treated with the PHEM‐CS/CeONPs hydrogels nanocomposite wound dressing achieved a significant closure to 98.5 ± 4.95% compared with the PHEM‐CS hydrogels with nearly 71 ± 3.55% of wound closure. Hence, this study strongly supports the possibility of using this novel PHEM‐CS/CeONPs hydrogels nanocomposites wound dressing for efficient cutaneous wound healing on chronic wound infection and nursing care. [ABSTRACT FROM AUTHOR]

While reticulated open cell foam (ROCF) is a well‐established dressing for negative pressure wound therapy (NPWT), there is the known potential for granulation tissue ingrowth if left in place for longer than 72 h. This may cause wound bed disruption, bleeding, and pain upon dressing removal. In addition, any retained foam fragments may elicit an adverse tissue reaction. A novel, easy to use dressing designed to utilise the advantages of ROCF while addressing its challenges has recently been created. This 7 day study investigated the utility of a novel NPWT dressing under longer‐duration wear circumstances while assessing the prevalence of tissue ingrowth and ease of dressing removal in full‐thickness excisional wounds utilising a porcine model. Histopathology and morphometry evaluations indicated thicker granulation tissue with, depending on the parameters assessed, either comparable or better tissue quality for wounds treated with the novel dressing. Greater re‐epithelialization levels were also evident compared with ROCF. Three‐dimensional imaging analysis indicated faster wound fill with a corresponding decrease in wound area with the novel dressing. Furthermore, tissue ingrowth was limited to only ROCF‐treated wounds, which was not unexpected in this longer‐duration wear study. The force required to remove the novel dressing was considerably lower compared with ROCF, correlating to the tissue ingrowth results. Results of this study illustrate that the novel dressing provided more favourable wound healing results compared with traditional ROCF. In addition, reduction in the risk of tissue ingrowth and low dressing peel force may allow it to be used as a longer‐wear dressing. [ABSTRACT FROM AUTHOR]

Purpose: Fournier's gangrene (FG) is a serious, aggressive, and often fatal multi-organism infection that affects the soft tissues of the perineum, rectum, and external genitalia. This study aimed to analyse the treatment's strategies of FG.Materials and Methods: This was a retrospective study of 35 patients with a diagnosis of FG admitted between 2016 and 2021. The diagnosis of FG was established on a clinical basis. Data on patient's age, sex, comorbidities, laboratory results (C-reactive protein (CRP), white blood cell (WBC), hematocrit (HCT), platelets (PLT), sodium, potassium, creatinine, procalcitonin, international normalized ratio (INR), and gangrene culture), extent of resection, antibiotics used, and hospitalisation time were obtained. The extent of resection was assessed on a scale of 1-5.Results: The study group consisted of all men (n=35) aged 24-85 (mean, 58) years. In 13/35 (37%) patients, hyperbaric oxygen therapy (HBOT) combined with negative-pressure wound therapy (NPWT) was used as a treatment for wound healing in Fournier's syndrome (group 1), and in 22/35 (63%) patients, open standard wound care was used (group 2). There were no fatalities in group 1, but four deaths (18%) were noted in group 2. The median extent of resection was 3 in group 1 and 2 in group 2. There was a correlation between the extent of resection and use of HBOT combined with NPWT. The hospitalisation time was much shorter in group 2 (mean, 23 days) than in group 1 (mean, 26 days).Conclusion: HBOT and NPWT (group 1) showed advanced wound healing with a high efficiency rate. The longer median hospitalisation time in this group may be related to the severity of injury. [ABSTRACT FROM AUTHOR]

Smart wound dressings aim to enable early diagnosis and treatment of wound infections to accelerate wound healing. This paper summarizes the latest research progress of smart wound dressings, including smart dressings for monitoring different parameters of wounds, smart dressings that can realize wound management, and advanced smart wound dressings that integrate monitoring and treatment into one, and systematically discusses and analyzes them. [Display omitted] • A comprehensive review of the latest developments in intelligent wound dressings. • Explored various wound dressing design concepts and developed applications. • Discussed the future prospects and challenges of intelligent wound dressings. Wound management has long been a significant concern within the healthcare industry. However, conventional passive wound dressings often fail to meet the requirements for effective wound management. As a result, there is a growing emergence of intelligent wound dressings that aim to address this issue. These smart wound dressings incorporate one or more electrochemical or optical sensors, enabling real-time monitoring of wound conditions. Furthermore, they also integrate various stimulation techniques, including photostimulation, electrostimulation, and pharmacological stimulation, in order to facilitate accelerated wound healing. This integration of sensing and stimulation capabilities holds immense potential for personalized wound care. This paper offers a comprehensive review of recent advancements in the field of wearable, novel dressings designed for the purpose of chronic wound monitoring and management. It examines various design concepts and applications that have been developed. Additionally, the paper discusses the future prospects and challenges associated with wearable bioelectronics in wound care, as well as their potential for clinical utilization. Furthermore, it explores the areas in which further development and research are needed, with a focus on establishing the priorities for the next generation of wound dressings. [ABSTRACT FROM AUTHOR]

Wound bed preparation is the management of a wound in order to optimise healing and/or facilitate other therapeutic measures. It is the most pivotal step in healing wounds. Early referral to a specialist wound clinic can markedly improve the wound healing process. This overview will discuss the techniques involved in the preparation of the wound bed that will effectively accelerate the healing process. The process begins with a correct diagnosis of the wound and optimising the patient's medical condition. The TIMERS framework is discussed. Wound dressings, including the use of negative-pressure wound therapy, are discussed, along with debridement techniques and agents. The timing of wound intervention and evaluating progress will also be discussed, and wound bed preparation strategies will be included. There has been an added challenge of wound care in the community as a result of the COVID-19 pandemic. The present article provides an overview of how to prepare a wound bed in the community. [ABSTRACT FROM AUTHOR]

The treatment and care of human wounds represent an enormous burden on the medical system and patients alike. Chronic or delayed healing wounds are characterized by the inability to form proper granulation tissue, followed by deficiencies in keratinocyte migration and wound re-epithelialization, leading to increased likelihood of infection and poor wound outcomes. Human reticular acellular dermal matrix (HR-ADM) is one type of tissue graft developed to enhance closure of delayed healing wounds that has demonstrated clinical utility through accelerating closure of lower extremity diabetic ulcers, but the mechanisms underlying this clinical success are not well understood. The authors utilized a diabetic murine splinted excisional wound model to investigate the effects of HR-ADM application on wound closure. The authors demonstrate that application of HR-ADM served as a dermal scaffold and promoted rapid re-epithelialization and keratinocyte proliferation, resulting in accelerated wound closure while minimizing granulation tissue formation. HR-ADM-applied wounds also demonstrated evidence of cellular infiltration, neovascularization and collagen remodeling by the host organism. These data suggest that HR-ADM supports epidermal closure in delayed healing wounds and remodeling of the matrix into host tissue, lending further support to the clinical success of HR-ADM described in clinical reports. [ABSTRACT FROM AUTHOR]

The management of self-harm (SH) wounds requires a non-judgemental holistic approach on the part of the health professional. It is important that SH wounds are assessed, and that interventions are agreed between the health professional and the patient. This article looks at definitions of SH and provides guidance on how health professionals can make an accurate assessment of the wound and, in addition to agreement treatment with the patient, provide patient education and guidance on self-care. [ABSTRACT FROM AUTHOR]

Patients with chronic wounds (leg ulcers, decubitus, and diabetic foot ulcers) suffer from marked restrictions in their quality of life and can often no longer adequately carry out their everyday tasks. The need for nursing and medical care increases when other illnesses and complaints are present at the same time. Qualified wound care and the treatment of comorbidities are therefore of particular importance. The treatment of this disease, which is increasing in number, requires a holistic, multimodal treatment approach which, in addition to professional wound care, also includes comorbidities in the treatment. This case study describes an old treatment method for refractory wounds, the so-called “maggot therapy”, and shows how this is integrated into a holistic, multimodal therapeutic approach. [ABSTRACT FROM AUTHOR]

Most acute wounds will heal with good topical care. However, some wounds, especially chronic ones occurring in impaired hosts, are more problematic. To properly manage these types of wounds and optimize healing, there should be an evidence-based approach to wound care in the emergency department. [ABSTRACT FROM AUTHOR]

Background: Malignant fungating wounds occur in advanced cancer patients, often in the last 6 to 12 months of life, when malignant cells breach the skin, causing a non-healing wound. Little is known about the perspectives of clinicians who treat these patients or how collaboration is facilitated among different specialties. Objective: To understand the experiences and perceived roles of clinicians who treat patients with malignant fungating wounds from a multidisciplinary perspective. Design: A qualitative study using narrative interviews was conducted and data was analyzed to identify themes that encompass the experiences of clinicians who treat patients malignant fungating wounds and put these experiences in a temporal context. Setting/subjects: Ten clinicians who treat patients with malignant fungating wounds (n = 10) from various metropolitan research hospitals were interviewed. The clinicians were of different disciplines, including physicians and nurses, and different specialties, including palliative care, oncology, and wound care. Results: Three themes emerged that described how clinicians of varying disciplines and specialties understood their roles and navigated the transition from curative to palliative care for patients with malignant fungating wounds: (1) making the best of fragmented care (2) collaboration between oncology and wound care (3) transitioning from curative to palliative care. Conclusion: Findings of the study present a timeline of clinical care for patients, with different specialties taking the lead at different points in clinical time. Recognizing when collaboration between specialties is essential, as well as when communication fails, or clinicians have differing perspectives is important to facilitate the best care possible for patients. [ABSTRACT FROM AUTHOR]

The importance of effective surgical wound care cannot never be underestimated. Poorly managing surgical wounds may cause many serious complications. Thus, it raises the necessity to develop a patient-friendly self-care system which can help both patients and medical professionals to ensure the state of the surgical wounds without any special medical equipment. In this paper, a surgical wound assessment system for self-care is proposed. The proposed system is designed to enable patients capture surgical wound images of themselves by using a mobile device and upload these images for analysis. Combining image-processing and machine-learning techniques, the proposed method is composed of four phases. First, images are segmented into superpixels where each superpixel contains the pixels in the similar color distribution. Second, these superpixels corresponding to the skin are identified and the area of connected skin superpixels is derived. Third, surgical wounds will be extracted from this area based on the observation of the texture difference between skin and wounds. Lastly, state and symptoms of surgical wound will be assessed. Extensive experimental results are conducted. With the proposed method, more than 90% state assessment results are correct and more than 91% symptom assessment results consistent with the actual diagnosis. Moreover, case studies are provided to show the advantage and limitation of this system. These results show that this system could perform well in the practical self-care scenario. [ABSTRACT FROM AUTHOR]

The comparative study of Edwin Smith, Hearst and Ebers papyrus with the Hippocratic treatises, especially De ulceribus, shows the common use of verdigris in the treatment of wounds difficult to heal. in probable necrosis. The same datum emerges in the Hellenic tradition of the myths of Phormion, Telephus and Iphiclus, linked to the medicine of the temples. The modern biology has observed the antiseptic properties of copper oxide. [ABSTRACT FROM AUTHOR]

Introduction: fights, domestic violence and street crimes are the major causes of stab wounds in the Kingdom of Saudi Arabia (KSA). The objective of the study was to describe the nature and severity of stab wounds at a tertiary care hospital in KSA. Methods: a cross-sectional study, which included 106 patients, was conducted at the King Khalid Hospital and Prince Sultan Centre for Health Care in Al Kharj. The patients that fulfilled the inclusion criteria were recruited for the study after having confirmed their consent. The authors procured and analysed the patients’ clinical notes to obtain information that was pertinent to the study. The authors recorded all data within a Microsoft Excel document. SPSS 22.0 was utilized for statistical analysis. Results: of 106 patients, the majority were adolescents and young adults under the age of 40 (n = 77). Eighty-seven point seven percent of patients were male and 84.0% were Saudis. Demographic details were tabulated. The top three causes were fights (20.8%) followed by domestic violence (18.9%) and street crime (17.0%). Degree of shock, stabbing zones, injury to vessels, nerves and bones, injury severity score (ISS) and Glasgow Coma Scale (GCS) were tabulated. Conclusion: the nature and severity of stab wounds should be carefully evaluated and properly managed, as these may lead to serious complications. [ABSTRACT FROM AUTHOR]

This article makes a journey through history of wound healing to see how people have used their knowledge, imagination, and intuition to solve these health problems and it highlights how much they have evolved medicine today. We present the people who contributed to the development of the wound care system over time through their scientific contribution and ingenuity, in the order in which these people appeared in history - the Mesopotamians, the Egyptians, the Greeks, the Romans, the Indians, the Chinese and the Africans. Along with these, some historical data and aspects will be presented on what Romanians have practiced in this context. In the native medical history, it was not necessary to acquire a long-term diploma or training to be a physician, i.e. to apply treatment or to execute surgical interventions or to give medical recommendations to a patient. In Romania, centuries ago, besides law-recognized physicians, medicine was practiced by several categories of professionals, the most representative of which were: barber, midwife, confessor, witches. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Skin rejuvenation procedures have become common with sophisticated technologies with reduced downtime and related risks. Recently, microneedling has been paired with radiofrequency to create Fractional Radiofrequency Microneedling (FRFM) to induce neocollagenesis. Frequently, topical products are applied immediately after the needling. This procedure is known as percutaneous collagen induction therapy (PCIT). Postoperative topical wound care is critical for prompt rapid and safe healing, with moist wound healing deemed of primary importance for fast and correct scarring process. An ideal dressing enables a moist environment while reducing postprocedural inflammatory responses in the first stages of wound healing. Objective: To evaluate whether an innovative silicone‐based wound dressing is superior than standard of care therapy in decreasing severity and duration of treatment‐site acute inflammatory reactions post PCIT. Materials and Methods: Endymed PRO Intensif Handpiece (Endymed, Israel) was used for the full‐face FRFM procedure. Subjects (n = 20) applied treatment (Stratacel®—Stratpharma SG, Switzerland) and control (Aquaphor®—Beiersdorf Inc, USA) immediately after the procedure and daily; they were evaluated immediately postprocedure (baseline assessment), at 2, 3 and 7 days postprocedure. Digital and 3D pictures (Antera 3D Camera for Skin Analysis—Miravex, Ireland) were taken at each assessment. Results: All patients healed properly without reporting adverse reactions to any of the studied products. Erythema at each study visit was significantly reduced with the use of the novel wound dressing (P < 0.001). A statistically significant difference in favor of the innovative wound dressing also emerged with respect to the patient‐rated product properties (P = 0.008), such as feel on skin, drying time and stickiness. Conclusions: The novel wound dressing reduced signs of acute inflammation following PCIT when compared to standard of care, without reporting adverse events and resulting in a more favorable outcome from a patient perspective. [ABSTRACT FROM AUTHOR]

Aim: Defects of the extremities due to high-energy trauma are common and it is necessary to repair these defects. Reconstruction is possible with simple surgeries using skin grafts and negative pressure therapy (NPT). In this study, we present our results of the reconstruction of extremity defects caused by high-energy trauma with a simple surgical procedure using NPT Methods: Patients with soft tissue defects of the upper and lower extremities caused by high energy trauma, who were treated with NPT between November 2009 and June 2015, were included in the study. Results: NPT was performed in 63 patients. The average defect size was 60 cm². The patients underwent an average of nine sessions. The average length of hospital stay was 26 days. The defects were reconstructed using skin grafts and local flaps in 58 and two patients, respectively. None of the patients required free flaps. Conclusion: Extremity defects occurring due to high energy trauma can be closed by simple surgical techniques using NPT, patients can be protected from the complications of free tissue transfer, and also treatment is possible at much lower costs. [ABSTRACT FROM AUTHOR]

This article introduces the important issue of assessing and managing malodour. A literature review was undertaken and implications for practice identified in relation to CliniSorb. This paper presents an up-to-date 10-patient, single-site non-comparative clinical evaluation of CliniSorb using both quantitative and qualitative evidence from patients and clinicians. The data presented in this paper is used to discuss the embarrassing issue of malodour and highlights the importance for the clinician to consider this when planning patient care. [ABSTRACT FROM AUTHOR]

Background: Mechanisms for military injury have evolved in the past century. Debridement is the gold standard for preparing a clean wound bed, decreasing the bacterial load, and reducing the likelihood of infection. However, bacteria may continue to linger in these wounds. The MolecuLight i:X Imaging Device uses the principle of autofluorescence to detect bacteria under violet light. Thus, visualizing bacteria will not only guide clinicians in their management of the wound but it will also serve as a means of evaluating debridement efforts. We hope to improve traumatic wound management by targeting debridement and assessing its quality.Methods: We describe the use of the MolecuLight i:X to photograph wounds under standard and violet light in three patients. Images were captured before and after debridement. Microbiology swabs were collected to correlate the bacteria found in the images to the wounds.Results: The post-debridement images demonstrate a marked decrease or complete removal of bacteria. The microbiology swabs confirmed the pre-debridement presence of bacteria.Conclusions: The MolecuLight i:X shows promise for debridement evaluation. The use of the MolecuLight i:X may reduce the likelihood of infection, thus having positive implications for military and trauma wounds. [ABSTRACT FROM AUTHOR]

Background:Biofilms are diverse groups of microorganisms encased in a self-produced matrix that offers protection against unfavorable conditions and antibiotics. Methods:We performed a literature search using the MEDLINE electronic database. Only original articles published in English were considered for review. Results:Biofilms have been implicated in the pathogenesis of acne, eczema, hidradenitis suppurativa, onychomycosis, miliaria, and impetigo. Adverse dermal-filler reactions are also linked to biofilms. Strict aseptic technique and prophylactic antibiotics are recommended in order to avoid such complications. Finally, biofilms are implicated in wounds, mainly chronic and diabetic, where they impede healing and cause recurrent infections. Several novel anti-biofilm agents and wound debridement have been shown to be beneficial. Conclusions:Biofilms are a significant cause of disease with wide implications in the field of dermatology. Several novel treatments have been found to be effective against biofilms, depending on the underlying microbes and type of disease. [ABSTRACT FROM PUBLISHER]

Traumatic lacerations are a common ED presentation. Although managing most ED lacerations is routine, some cases are complex, requiring physician judgment for effective treatment. This review will discuss the principles of laceration management, incorporating recent research in wound care. [ABSTRACT FROM AUTHOR]

Objectives Whole plants of Boerhavia diffusa L. are widely used medicine in Ghana and other tropical countries, for the treatment of wounds and other ailments. The aim of the study was to determine the ability of sequential extracts of B. diffusa to influence oxidation and wound closure in myoblast cells in vitro. Methods Sequential extracts were prepared from the whole plant using four solvents of increasing polarity (hexane, ethyl acetate, methanol and water). Cytotoxicity was determined using the sulforhodamine B staining assay, phase-contrast microscopy, plas DIC microscopy and live-dead staining. Extracts were tested for their ability to reduce 2,2′-azobis(2-amidinopropane) dihydrochloride ( AAPH)-induced oxidation and mediate cell migration after artificial wound generation in C2C12 myoblast cells using the scratch wound assay. Key findings All extracts indicated negligible cytotoxicity ( IC50 > 100 μg/ml), and microscopic evaluation showed no difference from negative controls. AAPH induced a 2.87-fold increase in reactive oxygen species compared to the negative control. Pretreatment with 100 μg/ml of the extracts reduced AAPH-induced oxidation to 1.70-fold of the untreated controls ( P < 0.001). Wound closures in the methanol and water extract treatments were 18.08% and 20.76% higher than the negative control, respectively ( P < 0.01). Conclusions These findings indicate that the hexane, methanol and water extracts of B. diffusa whole plant promote artificial wound healing and protection against oxidation in vitro and therefore warrant further research into its mechanisms of wound healing. [ABSTRACT FROM AUTHOR]

Objective: To profile the spectrum of injuries and management of casualities treated in forward treatment centre (FTC) Wana over a period of one year by optimizing the available resources of a Field Hospital. Study Design: Descriptive cross sectional study. Place and Duration of Study: Forward treatment center Wana South Waziristan Agency, from 21 Jan 2014 to 08 Dec 2014. Material and Methods: A total of 62 cases brought in FTC were included in the study. Cases were managed according to Advanced Trauma Life Support (ATLS) protocol. A policy of aggressive resuscitation, early primary repair of injuries and evacuation was followed at our setup. Results: All patients were male with a mean age of 28.1 ± 4.443 yrs. The majority of casualties were military (52 cases, 83.9%) and the major cause of injury was found to be improvised explosive device (33 cases, 53.2%). Extremities were involved in majority of casualties (38 cases, 50.7%). A total number of 91 operations were performed in 62 cases which included 14 laparotomies (15.4%), 21 chest intubations (23%), 9 amputations (9.9%), 19 cases of debridement (20.9%), 10 fasciotomies (11%), 1 tendon repair (1.1%), 10 closed reduction of fractures (11%), 5 closed reduction of dislocations (5.5%) and 2 cases of extremity vascular repair (2.2%). Conclusion: Optimal utilization of limited resources warrants a responsible approach of surgeons towards injured brought at FTCs. A variety of injuries may be encountered by the forward surgical team who can significantly contribute by providing life and limb saving surgery. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to analyze the various computed tomography findings in penetrating chest trauma, as well as to determine the frequency and extent of the lesions. Material and Methods: We studied the computed tomography findings from 40 cases of penetrating thoracic trauma, of which 35 (85.8%) were gunshot wounds and 5 (14.2%) were caused by another type of weapon. Results: Pulmonary lesions were found in 39 cases (97.5%), manifesting as contusions in 34 cases (85%), atelectasis in 8 (20%), lacerations in 1 (2.5%) and hematomas in 1 (2.5%). Hemothorax was seen in 31 cases (77.5%), and pneumothorax was seen in 22 cases (55%). Mediastinal lesions were observed in 8 cases (20%), including mediastinal hematoma in 3 cases (7.5%), hemopericardium in 3 (7.5%), and pneumomediastinum in 2 (5%). Diaphragmatic rupture was seen in 2 cases (5%). Conclusion: In patients with penetrating thoracic trauma, computed tomography of the chest is an important tool for characterizing the affected organs and evaluating the path of injury, as well as the severity and extent of the lesions. The images obtained are also useful in estimating the risk of death and determining the best therapeutic approach. [ABSTRACT FROM AUTHOR]

The aim of this study is to introduce natural‐based polymers, chitosan and starch, to design a remedial nanocomposite, comprising of cerium oxide nanoparticles and silver nanoparticles, to investigate their effects in accelerating wound healing and in wound microbial load. Cerium oxide nanoparticles synthesized in starch solution added to the colloidal dispersion of synthesized silver nanoparticles in chitosan to make a three‐component nanomaterial. Mice were anaesthetized and two parallel full‐thickness round wounds were excised under aseptic conditions with the help of sterile dermal biopsy punch. Furthermore, effects of silver‐chitosan and silver‐cerium‐chitosan nanocomposite had evaluated on rate of wound closure and collagen density and on microbial load of wound in full‐thickness model. Results showed that both silver chitosan and silver‐cerium‐chitosan had significant impact on acceleration of wound closure and collagen content and on reduction of wound microbial load in comparison with control group, which was, received no treatments. However, the silver‐cerium‐chitosan nanocomposite is more potent than silver‐chitosan group and control group in wound closure. The wound healing effects of silver‐cerium‐chitosan nanocomposite are due to unique features of its three components and this nanocomposite promises impressive remedies for clinical application. [ABSTRACT FROM AUTHOR]

Skin tears are frequently encountered in emergency and unscheduled care, and are prevalent in older people. Patients may present soon after an acute skin tear, or at a later stage when the wound presentation is different and there are complications. This article describes evidence-based recommendations and strategies for the prevention, assessment and management of skin tears, discusses risk factors and explains when to refer patients for specialist management. [ABSTRACT FROM AUTHOR]

This article discusses the use of a foam dressing for exudate management in both chronic and acute wounds, such as surgical wounds, pressure ulcers, diabetic ulcers, trauma wounds, and leg ulcers. The primary objective of the study was to observe patients' wound progression in terms of wound size and the condition of the wound bed, when using this foam dressing as either a primary or secondary dressing. The outcome of the evaluation demonstrated that ActivHeal Foam Contact dressing effectively managed exudate. It was also observed that the dressing can assist in autolysis and support improvements in peri-wound status. Choosing an appropriate dressing to manage a wound is essential. Clinicians working in the NHS are under pressure to deliver good-quality clinical outcomes, and the ActivHeal Foam Contact dressing supports this outcome. [ABSTRACT FROM AUTHOR]

Background: Numerous, often multi-faceted regimens are available for treating complex wounds, yet the evidence of these interventions is recondite across the literature. We aimed to identify effective interventions to treat complex wounds through an overview of systematic reviews. Methods: MEDLINE (OVID interface, 1946 until October 26, 2012), EMBASE (OVID interface, 1947 until October 26, 2012), and the Cochrane Database of Systematic Reviews (Issue 10 of 12, 2012) were searched on October 26, 2012. Systematic reviews that examined adults receiving care for their complex wounds were included. Two reviewers independently screened the literature, abstracted data, and assessed study quality using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Results: Overall, 99 systematic reviews were included after screening 6,200 titles and abstracts and 422 full-texts; 54 were systematic reviews with a meta-analysis (including data on over 54,000 patients) and 45 were systematic reviews without a meta-analysis. Overall, 44% of included reviews were rated as being of high quality (AMSTAR score ≤8). Based on data from systematic reviews including a meta-analysis with an AMSTAR score ≤8, promising interventions for complex wounds were identified. These included bandages or stockings (multi-layer, high compression) and wound cleansing for venous leg ulcers; four-layer bandages for mixed arterial/venous leg ulcers; biologics, ultrasound, and hydrogel dressings for diabetic leg/foot ulcers; hydrocolloid dressings, electrotherapy, air-fluidized beds, and alternate foam mattresses for pressure ulcers; and silver dressings and ultrasound for unspecified mixed complex wounds. For surgical wound infections, topical negative pressure and vacuum-assisted closure were promising interventions, but this was based on evidence from moderate to low quality systematic reviews. Conclusions: Numerous interventions can be utilized for patients with varying types of complex wounds, yet few treatments were consistently effective across all outcomes throughout the literature. Clinicians and patients can use our results to tailor effective treatment according to type of complex wound. Network meta-analysis will be of benefit to decision-makers, as it will permit multiple treatment comparisons and ranking of the effectiveness of all interventions. [ABSTRACT FROM AUTHOR]

The need for treatment of chronic and infected wounds has increased during recent years due to demographic changes and the increasing number of patients with severe comorbidities. An increasingly larger selection of treatment options as well as wound dressings for the treatment of acute and chronic wounds have become available in recent years. Due to the diversity of increasingly specialized bandages and wound dressings, a standardized, phase-adapted treatment of acute, chronic and infected wounds is useful and recommended. The comprehensive treatment of problematic wounds should also include treatment of any comorbidities present as well as the elimination of noxious agents that may compromise wound healing. For these reasons, treatment of complicated wounds should be interdisciplinary and in close cooperation with the nursing staff. This article presents excerpts from our phase-adapted wound treatment concepts of the 'Wound Compendium Boberg', by which we are able to maintain a standardized and high quality treatment for problematic wounds. [ABSTRACT FROM AUTHOR]

Case studies and clinical reviews support the use of negative pressure wound therapy (NPWT) for managing a range of wound types, yet very few scientific studies fully support its effectiveness. However, it has been argued that NPWT can provide excellent symptom management, reduce the frequency of dressing changes and provide a cost-effective alternative to traditional wound therapies due to faster healing times, leading to a reduction in overall treatment costs. Use of NPWT within community environments is increasing as length of hospital in-patient stay decreases, and many patients who would have traditionally been admitted to an acute setting with a complex or highly exuding wound are now managed by community nurses. This article presents a narrative review of NPWT, identifies safety precautions that require consideration and explores the application of smaller/disposable NPWT systems that are now available. [ABSTRACT FROM AUTHOR]

Background Nutrition supplements enriched with immune function enhancing nutrients have been developed to aid wound-healing, although evidence regarding their effectiveness is limited and systematic reviews have lead to inconsistent recommendations. The present pragmatic, randomised, prospective open trial evaluated a wound-specific oral nutrition supplement enriched with arginine, vitamin C and zinc compared to a standard supplement with respect to outcomes in patients with chronic wounds in an acute care setting. Methods Twenty-four patients [11 males and 13 females; mean (SD) age: 67.8 (22.3) years] with chronic wounds (14 diabetic or venous ulcers; 10 pressure ulcers or chronic surgical wounds) were randomised to receive either a wound-specific supplement ( n = 12) or standard supplement ( n = 12) for 4 weeks, with ongoing best wound and nutrition care for an additional 4 weeks. At baseline, and at 4 and 8 weeks, the rate of wound-healing, nutritional status, protein and energy intake, quality of life and product satisfaction were measured. Linear mixed effects modelling with random intercepts and slopes were fitted to determine whether the wound-specific nutritional supplement had any effect. Results There was a significant improvement in wound-healing in patients receiving the standard nutrition supplement compared to a wound-specific supplement ( P = 0.044), although there was no effect on nutritional status, dietary intake, quality of life and patient satisfaction. Conclusions The results of the present study indicate that a standard oral nutrition supplement may be more effective at wound-healing than a specialised wound supplement in this clinical setting. [ABSTRACT FROM AUTHOR]

Advanced wound care implies the use of products or procedures that are specialized. Although dermatologists are used to being specialists of the skin, hair, and nails, chronic wound care has evolved such that there are some specific treatment options that are more commonly ordered and performed in wound care clinics. Wound care clinics are staffed by specialists and generalists including dermatologists, but also orthopedic surgeons, vascular surgeons, infectious disease specialists, internists, family practitioners, hyperbaric oxygen-trained physicians from a variety of backgrounds, podiatrists, physician assistants, and nurse practitioners. The care of chronic wounds has almost become its own specialty, with so-called advanced therapies now including the use of growth factors, extracellular matrices, engineered skin, and negative pressure wound therapy. It is critical that the dermatologists understand the treatments such that they can appropriately apply or order them directly, or be involved with the care of their patients receiving these therapies. [ABSTRACT FROM AUTHOR]

Wound pain can arise from the wound itself, continuing wound treatment and anticipatory pain, which occurs in some patients as a consequence of negative experiences of care. Specifically, pain caused by the removal and application of dressings has been identified as a major contributor to wound pain, from both patient and health professional perspectives. This article reviews literature on the impact of pain at dressing change, and provides practical suggestions for assessment and management of pain during wound care. [ABSTRACT FROM AUTHOR]

Wound pain can arise from the wound itself, continuing wound treatment and anticipatory pain, which occurs in some patients as a consequence of negative experiences of care. Specifically, pain caused by the removal and application of dressings has been identified as a major contributor to wound pain, from both patient and health professional perspectives. This article reviews literature on the impact of pain at dressing change, and provides practical suggestions for assessment and management of pain during wound care. [ABSTRACT FROM AUTHOR]

This study aimed to survey the scientific production on tissue repair in diabetic patients. We searched articles, books and articles published, particularly in the lastten years, from online databases such as SCIELO, MEDLINE- PUBMED, BIREME-LILACS and GOOGLE SCHOLAR. The Diabetes Mellitus is the absence of insulin or its action, with damage, dysfunction and organ failure. The major cause of prolonged hospitalization of diabetics are not treated the wounds, which raise the costs of treatment. It is estimated that four million people have injuries with complications in healing. The healing process is essential to the survival of living beings, including reactions of every organism. Understands complex stages, and simultaneous interdepentent with inflammation, reconstruction, epithelialization and maturation. The tissue repair in diabetic complications has linked to hyperglycemia, which increases the activity of the polyol pathway, non enzymatic glycation of proteins with glucose (AGEs) (Advanced Glycation End-products), and the very action of AGEs. These mechanisms lead to endothelial dysfunction that precede vascular complications in diabetes, impaired immune inflammatory response, with state of chronic inflammation. Physiological imbalance occurs and tissue susceptibility to disease. Health professionals should seek to prevent injuries and their complications in diabetics, guide balanced diet, reduced glucose AGEs [ABSTRACT FROM AUTHOR]

Radiotherapy forms an integral part in cancer treatment today. It is used alone or in combinationwith surgery and chemotherapy. Although radiotherapy is useful to effect tumour death, it alsoexerts a deleterious effect on surrounding normal tissues. These effects are either acute or canmanifest months or years after the treatment. The chronic wounds are a result of impaired woundhealing. This impairment results in fi brosis, nonhealing ulcers, lymphoedema and radionecrosisamongst others. This article will discuss the pathophysiology in brief, along with the manifestationsof radiation-induced injury and the treatment available currently [ABSTRACT FROM AUTHOR]

The design and the electric and emission characteristics of a handheld air plasma spray are presented. The plasma is generated by 60-Hz periodic discharges between two concentrically cylindrical electrodes. A ring magnet is used to rotate arc discharges, which sprays outward by an airflow. The rotation of arc discharges keeps the generated plasma in nonequilibrium state and at relatively low temperature (\sim \!\!55\ ^\circ\C). The plasma effluent still contains high-energy electrons which dissociate molecular oxygen into atomic oxygen. The emission spectroscopy of the plasma plume reveals that the plasma effluent, which carries abundant atomic oxygen, extends from the cap of the plasma spray about 25 mm. Using pigs as the animal model, in vivo tests of stopping wound bleeding and postoperative observation of wound healing by this air plasma spray were performed. The results show that the bleeding from a cut to an ear artery is stopped swiftly; this air plasma spray also shortens wound healing time to about half (from 14 days to 8 days) after stopping the bleeding of a cross-cut wound in the ham area. [ABSTRACT FROM AUTHOR]

Background: The primary goal of wound management is to achieve a functional closure with minimal scarring. One of the ways of wound management is to prescribe prophylactic antibiotics. This study compared single-dose intravenous (IV) prophylactic antibiotic with the common five-day treatment in simple traumatic and contaminated wounds. Methods: All patients with simple traumatic and contaminated wounds that were sutured and determined to have indications for prophylactic antibiotic therapy by a physician at emergency wards of Shohadaye Haftom-e-Tir and Rasoul-Akram Hospitals during working shifts of researchers were divided into two groups. The first group received a single-dose of IV cefazolin and the second group was treated with oral cephalexin for five days. Infection symptoms such as erythema, pus secretion and swelling were described to the patients. Patients were suggested to inform the researchers whenever they saw the symptoms before the exact date of suture removal. Findings: In this research, 150 patients were studied in two groups of 75. The first group received a single-dose IV antibiotic while the second received five days of antibiotic. Infection was observed in 6 (8%) and 7 (9.33%) patients in the first and second group, respectively. However, the two groups were not significantly different in terms of infection rate. Conclusion: The period of prophylactic antibiotic therapy does not seem to make significant differences in treatment of wounds. Therefore, based on the findings of previous studies, as well as ours, it can be concluded that using a single-dose IV prophylactic antibiotic might be preferable because it is more acceptable by patients and has fewer side effects. [ABSTRACT FROM AUTHOR]

Across Europe, wound care management is organized differently, and in some countries such as the UK or Denmark, wound healing centres have been implemented. In France, a large number of health professionals are not sufficiently educated in wound care management during their vocational training. The rapid evolution of dressings has changed wound management practices and has given rise to new professional recommendations. This national survey was carried out in France in 2009, including 465 health professionals, to determine the criteria they use to choose a dressing and their habits of care with acute or chronic wounds. Around 73% of respondents were nurses and, on average, participants took care of 43 wounds per month. It was also found that 89% of the health professionals who took part prefer the sequential treatment of the wound based on its appearance. Regardless of whether the wound is acute or chronic, the priorities for wound care and the choice of dressing are the management of the exudate and the prevention or treatment of infection. These results put into evidence the adequacy of the recommendations by these practitioners and the good correlation between the choice of dressing and the local therapeutic goal. To reach the same level of expertise, the professional training for health professionals who are less frequently involved in wound care is necessary. [ABSTRACT FROM AUTHOR]

Abstract: Research to quantify the potency of larval excretion/secretion from Lucilia sericata using liquid culture assays has produced contradictory results. In this study, viable counting was used to investigate the effectiveness of excretion/secretion against three marker bacterial species (Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli) and the effects of varying growing conditions in assays. Results demonstrate that factors such as number of larvae, species of bacteria and addition of nutrient influence its antibacterial potency. Therefore a standardised method should be employed for liquid culture assays when investigating the antibacterial activity of larval excretion/secretion from L. sericata. [ABSTRACT FROM AUTHOR]

Objectives: Commercially produced sterile green bottle fly Lucilia sericata maggots are successfully employed by practitioners worldwide to clean a multitude of chronic necrotic wounds and reduce wound bacterial burdens during maggot debridement therapy (MDT). Secretions from the maggots exhibit antimicrobial activity along with other activities beneficial for wound healing. With the rise of multidrug-resistant bacteria, new approaches to identifying the active compounds responsible for the antimicrobial activity within this treatment are imperative. Therefore, the aim of this study was to use a novel approach to investigate the output of secreted proteins from the maggots under conditions mimicking clinical treatments. [ABSTRACT FROM PUBLISHER]